{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T09:46:08Z","timestamp":1772531168678,"version":"3.50.1"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003107","name":"Federal Ministry of Health","doi-asserted-by":"crossref","award":["2520DAT66A"],"award-info":[{"award-number":["2520DAT66A"]}],"id":[{"id":"10.13039\/501100003107","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Lower Saxony \u201cVorab\u201d of the Volkswagen Foundation"},{"name":"Center for Digital Innovations"},{"DOI":"10.13039\/501100010570","name":"Ministry for Science and Culture of Lower Saxony","doi-asserted-by":"crossref","award":["ZN3491"],"award-info":[{"award-number":["ZN3491"]}],"id":[{"id":"10.13039\/501100010570","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003One of the major challenges in pediatric intensive care is the detection of life-threatening health conditions under acute time constraints and performance pressure. This includes the assessment of pediatric organ dysfunction (OD) that demands extraordinary clinical expertise and the clinician's ability to derive a decision based on multiple information and data sources. Clinical decision support systems (CDSS) offer a solution to support medical staff in stressful routine work. Simultaneously, detection of OD by using computerized decision support approaches has been scarcely investigated, especially not in pediatrics.<\/jats:p><jats:p>\n          Objectives\u2003The aim of the study is to enhance an existing, interoperable, and rule-based CDSS prototype for tracing the progression of sepsis in critically ill children by augmenting it with the capability to detect SIRS\/sepsis-associated hematologic OD, and to determine its diagnostic accuracy.<\/jats:p><jats:p>\n          Methods\u2003We reproduced an interoperable CDSS approach previously introduced by our working group: (1) a knowledge model was designed by following the commonKADS methodology, (2) routine care data was semantically standardized and harmonized using openEHR as clinical information standard, (3) rules were formulated and implemented in a business rule management system. Data from a prospective diagnostic study, including 168 patients, was used to estimate the diagnostic accuracy of the rule-based CDSS using the clinicians' diagnoses as reference.<\/jats:p><jats:p>\n          Results\u2003We successfully enhanced an existing interoperable CDSS concept with the new task of detecting SIRS\/sepsis-associated hematologic OD. We modeled openEHR templates, integrated and standardized routine data, developed a rule-based, interoperable model, and demonstrated its accuracy. The CDSS detected hematologic OD with a sensitivity of 0.821 (95% CI: 0.708\u20130.904) and a specificity of 0.970 (95% CI: 0.942\u20130.987).<\/jats:p><jats:p>\n          Conclusion\u2003We could confirm our approach for designing an interoperable CDSS as reproducible and transferable to other critical diseases. Our findings are of direct practical relevance, as they present one of the first interoperable CDSS modules that detect pediatric SIRS\/sepsis-associated hematologic OD.<\/jats:p>","DOI":"10.1055\/a-1950-9637","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T23:09:25Z","timestamp":1664233765000},"page":"1002-1014","source":"Crossref","is-referenced-by-count":7,"title":["Tracing the Progression of Sepsis in Critically Ill Children: Clinical Decision Support for Detection of Hematologic Dysfunction"],"prefix":"10.1055","volume":"13","author":[{"given":"Louisa","family":"Bode","sequence":"additional","affiliation":[{"name":"Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Schamer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"B\u00f6hnke","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver Johannes","family":"Bott","sequence":"additional","affiliation":[{"name":"University of Applied Sciences and Arts Hannover, Faculty III \u2013 Media, Information and Design, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Marschollek","sequence":"additional","affiliation":[{"name":"Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Jack","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antje","family":"Wulff","sequence":"additional","affiliation":[{"name":"Peter L. 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